A recent Hawaiʻi study looked at sugar cane burning on the island of Maui and its effects on the respiratory system. The study was conducted by principle investigator Christina Mnatzaganian, a former assistant professor at the University of Hawaiʻi at Hilo Daniel K. Inouye College of Pharmacy and now an assistant professor at the Skaggs School of Pharmacy and Pharmaceutical Sciences in San Diego.
Karen Pellegrin, director of continuing/distance education and strategic planning at the UH Hilo pharmacy college, was responsible for the acquisition of the hospital data used in the study through a partnership with Hawaii Health Information Corporation. She also helped edit the manuscript and interpret the results and conclusions.
Also on the research team was Jill Miyamura of the Hawaiʻi Health Information Corporation, Diana Valencia from UH Mānoa and Lorrin Pang from the District Health Office of Maui.
The study, “Association between sugar cane burning and acute respiratory illness on the island of Maui,” which was published in the October 2015, Environmental Health journal, concluded that there was a “significantly higher incidence of respiratory distress in smoke-exposed regions when greater amounts of acres were burned.” It went on to suggest that health officials consider actions to help reduce the health risks associated with sugar cane burning.
Pellegrin is not surprised by the study findings. “We know that air pollution is associated with morbidity and mortality,” she says.
Only a few studies have been conducted with regards to cane burning and its effects. Many of those studies have been carried out in Brazil, and Pellegrin points out, “based on the findings, Brazil has passed a law requiring the gradual elimination of pre-harvest cane burning.” Preliminary studies in Brazil also have found a decrease in hospitalization due to respiratory illness correlating with a reduction in cane burning practices.
While conducting the study on Maui, a major factor that needed to be taken into account was vog from volcanic emissions on Hawaiʻi Island. According to Maui county regulations, cane burning is to take place only on days when vog is not present. This means that on non-burn days there is still an environmental factor responsible for higher occurrences of respiratory sickness. This can confound study results if researchers simply compare instances of respiratory distress on burn days versus non-burn days.
To be sure that they were isolating the effects of cane burning on the respiratory system, Mnatzaganian and Pang developed an innovative control through geographic examination. Pellegrin explains, “While vog pollutants affect the island evenly, burning only affects those regions downwind of the burn.” This regional analysis allowed the researchers to detect an association between the number of acres burned and prescriptions filled for acute respiratory distress using global positioning system mapping, wind direction and hospital and pharmacy data.
Enriching the discussion
The study is now contributing to discussions about sugar cane burning. The first case to be heard by Hawaiʻi’s recently established Environmental Court is a case filed to stop sugar cane burning on Maui and the study is already being referenced.
There are many challenges and benefits to living in such an isolated island state and sugar cane burning is a controversial topic with economical and health related importance.
“The field of rural health science is dedicated to understanding what factors in rural areas promote or harm health and finding solutions that can improve health,” Pellegrin says. She feels that the study makes a valuable contribution to the fields of environmental and rural health and hopes that it will have an impact on the unique health issues facing Maui.
—A UH Hilo Stories article by Lara Hughes, a junior at UH Hilo majoring in business administration and a public information intern in the UH Hilo Office of the Chancellor